Factors Determining the Need For Bilevel Therapy in Obstructive Sleep Apnea Patients

Objective:Except for continuous positive airway pressure (CPAP), which is the first choice in the standard treatment of Obstructive Sleep Apnea Syndrome (OSAS), it is recommended to continue treatment with bilevel PAP (BPAP) in patients, who cannot tolerate constant pressure or no success was achieved with this treatment. However, there is a group of patients without complicated OSAS and do not have BPAP indication at the first hospitalization, but for which adequate titration cannot be performed with CPAP. The purpose of this study was to investigate which characteristics of these patients or which data in their polysomnography (PSG) may be indicative of BPAP need.Materials and Methods:Comorbid diseases [diabetes mellitus (DM), cardiac diseases, pulmonary diseases], body mass index, neck/core/hip circumference measurements the patients evaluated with total sleep time, apnea-hypopnea index (AHI), hourly obstructive/central apnea and hypopnea numbers, mean desaturation index (ODI), rapid eye movement (REM) sleep latency, REM time, AHI in REM and non-REM (REM/non-REM index), average overnight saturation (SaO2), lowest saturation value (min O2%), time when saturation is below 90% overnight (T90), a position dependency in PSG.Results:Presence of DM, hypertension and cardiac disease, elevation of neck/core/hip circumference measurements, ODI, REM index, T90 values and ODI/SaO2 ratios were found to be statistically significant in the BPAP group, elevation in min O2% and SaO2 levels were found to be statistically significant in the CPAP group (p<0.05). It was determined that the probability of BPAP increased with the presence of DM 0.214 times, the presence of heart disease 0.205 times, a one-unit increase in the REM index 1.018 times, and a one-unit increase in T90 1.030 times. The REM index and T90, which were found to be significant in the receiver operating characteristic analysis, were determined as 70.850 and 56.150 cut-off values, respectively.Conclusion:In this study; it was determined that the probability of CPAP being insufficient and switching to BPAP increases with the presence of DM and heart disease; and that T90 and REM index, and their cutoff values can be used for this purpose. It was also thought that regional adiposity may affect the type of PAP to be used..

Medienart:	E-Artikel

Erscheinungsjahr:	2023
Erschienen:	2023

Enthalten in:	Zur Gesamtaufnahme - volume:10
Enthalten in:	Türk Uyku Tıbbı Dergisi - 10(2023), 1, Seite 78-83

Sprache:	Englisch ; Türkisch

Beteiligte Personen:	Nevra Güllü Arslan [VerfasserIn]

Links:	doi.org [kostenfrei] doaj.org [kostenfrei] jtsm.org [kostenfrei] Journal toc [kostenfrei]

Themen:	Bpap Cpap failure Medicine Medicine (General) Osas Osas treatment Prediction R

doi:	10.4274/jtsm.galenos.2022.27136

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	DOAJ080216439